Giving a painless injection

No one likes getting a shot. Cold, long, metallic, and oh so sharp, why do our local anesthesia instruments have to look so threatening? Quite frankly, they are not so ominous. They are often the thinnest guage and shortest needles on the market. Have you seen the needle your pediatrician uses to vaccinate your child? It is longer, thicker, and scarier. Even I look away when the vaccine comes.

Try as we dentists might, shots scare nearly all of our patients and if given improperly can be down right painful. Plus the aftereffects of the anesthesia are annoying…slurred speech, big fat lip, bitten tongue…. and are often prolonged. So how do we make the art of injection more pleasant?

Give a painless shot.

No, this is not an oxymoron.

Here is my technique. An excellent topical anesthetic is a must. I only use Hurricaine which is 20% Benzocaine like the other brands, but only this stuff works. The other brands DO NOT. Dry the tissue completely and apply the Hurricaine liberally. Cover it up with enough cotton so that no saliva gets through and let it sit for 5-10 minutes. Small talk, do a hygiene exam, pass the time and then remove all of the cotton. The patient will be really numb..topically, that is.

Your needle should be a 30 guage extra short…which means the thinnest, shortest, and smallest. Your local anesthesia is Septocaine 1:100,000 unless your patient can’t handle epinephrine. Tell them to open wide, position the injection where you need it, take hold of the lip, ask them to close halfway, shake their lip just before the needle punctures the tissue. Shake until you have about half a carpule in because after that it doesn’t matter.

Inject slowely.

The lip shaking is a great distraction. Ever heard of the Gateway Theory of Pain? The human brain can concentrate on only one major sensation at one time. So if you shake the lip hard enough…not too hard now…just before the prick, the prick is not felt. There is no prick. You will hear the delicious question dentists love…”What was that? Was that the needle?”